UPDATE OP: UPDATE: Septoplasty and Turbinate Reduction Recovery Time?

Oct 3, 13 8:26

Post #1 of 54 (43458 views)

I'm considering a septoplasty and a turbinate reduction surgery. I've suffered from sleep problems and constant congestion for years and years. I'm 27 years old and feel like a zombie all the time. I've been diagnosed with sleep apnea and have done the CPAP thing for the past two years. However, the CPAP is rendered basically useless because my nose is so restricted and I don't sleep with my mouth open. I'm hoping this surgery will help some with my sleep and get me feeling a bit better during the day.

I know this is ridiculous to think, but I don't want to be off the bike very long. I've recently upgraded to Category 3 cyclist and really want to get a good base training phase in this year. I have (almost) made my mind up that I'm definitely going to have the surgery, I just am worried I'll not be able to train for weeks and weeks. Of course I can just shift my season, but around here, the season starts late February/early Marhc. Can someone shed some light on how long I'll likely be totally off the bike? Or slap me silly and convince me to do it (or not do it) regardless of my training, etc. :-)

UPDATE: Scheduled the surgery for October 31st. I'm as nervous as a long-tailed cat in a room full of rocking chairs. . . . .

UPDATE #2

Had surgery yesterday. The procedure was quick; I went in to surgery at about 8:45AM and was home by noonish.

The general anesthesia was a different experience. I don't even recall them initiating the delivery. Maybe I just didn't realize it was being hooked up.

So far the pain isn't bad at all. The bleeding has basically stopped. I'm irrigating with saline every couple hours and keeping it all moist.

I was actually able to sleep last night for several hours. I have stents in my nose, but no big packing. So I was able to breathe some through my nose. Generally, I think I should be able to get recovered fairly quickly, but I'm going to be very diligent with recovery and doing what I have to do to get healed up ASAP.

Anyway, I'm off work today and bored. Just thought I would offer an update for anyone thinking about going through with the same procedure.

UPDATE #3

I'm now about 3 weeks post op. I had the splints removed after 5 1/2 days with them. They weren't bad for the first 2 days, but started to REALLY suck after the 4th day.

I was back on my bike 8 days after the surgery. Kept an agressive routine of saline washes and continue to do so. ENT thought it was a very successful surgery and so far, I agree. I'm sleeping better, but still healing. There is still some swelling, but I'm breathing better than I ever really have. So far, GREAT decision.

Last edited by: kmill23: Nov 21, 13 12:17

Re: Septoplasty and Turbinate Reduction Recovery Time? [kmill23] [ In reply to ]

Oct 3, 13 8:30

Post #2 of 54 (43452 views)

I had it done a few years ago; the fact that I've forgotten how long I was down is probably a good sign. On a basic level, though, you're seriously concerned about a temporary inconvenience vs. long term relief?

Eliot
blog thing - strava thing

Re: Septoplasty and Turbinate Reduction Recovery Time? [renorider] [ In reply to ]

Oct 3, 13 8:33

Post #3 of 54 (43448 views)

renorider wrote:

I had it done a few years ago; the fact that I've forgotten how long I was down is probably a good sign. On a basic level, though, you're seriously concerned about a temporary inconvenience vs. long term relief?

Thus my last statement regarding slapping me silly. On a more serious note, I guess I'm still searching for some indication on whether it's actually long term relief, a short term remedy which will require additional surgery down the road, or just a crap shoot. There is such a wide range of testimonials available, I'm not sure which way to turn.

Re: Septoplasty and Turbinate Reduction Recovery Time? [renorider] [ In reply to ]

Oct 3, 13 8:35

Post #4 of 54 (43443 views)

Hello
I ve done the septoplastie this winter (broken nose).
I ran 30' the day after surgery.

In fact you can t swim until the plastic thing in your nose (i m french don t know the name in english) will be remove -10 days generally-.
But as far as you don t bleed you can do the other sports

Re: Septoplasty and Turbinate Reduction Recovery Time? [kmill23] [ In reply to ]

Oct 3, 13 8:53

Post #5 of 54 (43432 views)

The septum surgery is 'relatively' easy. You'll be uncomfortable but, depending on the severity of the deviation, you could be back to work pretty fast. The turbinectomy was the thing that killed me. I won't go in to all the disgusting details on here, but feel free to email me and I can give you my take on the whole experience/recovery process (greg@triby3.com). The short answer to your question though- I had the surgery the second week in January this year and was fully back to training 4-5 weeks later. And by fully, I mean 100%. I was able to do some light cycling and running before that

Re: Septoplasty and Turbinate Reduction Recovery Time? [kmill23] [ In reply to ]

Oct 3, 13 8:59

Post #6 of 54 (43428 views)

I had the exact thing done in Jul on a Monday, I was riding and running by the weekend.

I did wait a couple weeks before I jumped in the dirty lakes around here though.

Re: Septoplasty and Turbinate Reduction Recovery Time? [kmill23] [ In reply to ]

Oct 3, 13 10:11

Post #7 of 54 (43413 views)

Had it done (both) in January 13. I was back in the gym 4 weeks later. Initial recovery was THE SUCK. One solid week of mysery. They don't tell you how bad it's going to be because I think you would not do it. Took a full 6-9 months for all the residual stuff to fully settle (some of the nerves in the roof of my mouth took a long time to stop tingling). Nothing earth shattering, just a little annoying.

On the plus side, my breathing is WAY better. I immediately saw improvements in all my training. Just more air going in. No more sleepless nights, no more lasting sinus infections. Seriously knocked 12 min off my sprint times (1:30 to 1:40 - longer sprint - 20 mile bike and 700m swim) and I attribute most of that gain just to the ease of breathing. One small hick-up is this I get a LOT of water in my nasal passages when I swim, if I'm not blowing hard out my nose. Just so much room now that the water flows more easily.

So in summary, it was more of a hassle than I thought at first but 9 mos removed, I am VERY happy I did it.

P.S. Buy Neilmed sinus irrigation pack from Costco. Works wonders to clear every thing out post surgery. Still use it every night before bed and I have no drainage/stuffiness issues, even in allergy season.

Peace!

Re: Septoplasty and Turbinate Reduction Recovery Time? [kmill23] [ In reply to ]

Oct 3, 13 10:46

Post #8 of 54 (43402 views)

Get it done. It's worth it in the long haul.

I had septoplasty & turbinate reduction a few years ago. My issue was chronic sinusitis, never on CPAP, but it still was a shitty quality of life.

Initial recovery was pretty rough, but that's 1-2 weeks. The initial removal of packing was an experience I will never forget.

Was a bit nasally & tender to cold for a few months, but was back to training after only a few weeks.

Swimming took longer to get back to obviously, but I think that was only about 6-8 weeks.

Looking back, it was definitely a good surgery to elect, turns out breathing is nice.

Re: Septoplasty and Turbinate Reduction Recovery Time? [kmill23] [ In reply to ]

Oct 3, 13 11:23

Post #9 of 54 (43391 views)

Best. Thing. I. Ever. Did.

I had the septoplasy, and turbinate reduction, and at the same time, I had my tonsils removed. When I was 30. I should have done this when I was 16.

You will most likely be off the bike a full month. BUT, because you'll be getting better sleep, and you'll breathe easier on the bike, you'll probably come back faster than ever. I know that my running and performance vastly improved after the surgery. In fact, I'm thinking about doing it again, since turbinates can grow back after a decade or so.

Punching cockroaches from day 1.

http://www.tri-junkie.com/

Re: Septoplasty and Turbinate Reduction Recovery Time? [kmill23] [ In reply to ]

Oct 3, 13 11:35

Post #10 of 54 (43386 views)

I'm an ENT, so I perform this surgery regularly. There's no easy answer as to how long your recovery will be. There are quite a few variables, mainly the severity of the deviation. For my motivated athletic patients, I usually tell them to lay off everything for the first week, then begin to ramp things back up the second week and see how it goes (mainly Z2). If you re-introduce high intensity work too soon, you could increase your risk of bleeding while things are still healing. So a reasonable approach would be to plan low intensity work during the second week, and reassess how you feel daily. If things are going well, you could gradually get back to your regular routine. What I've learned over the years, is that every patient recovers differently...and every ENT will give you a different answer as to post surgical activity restriction. If you give yourself that first week to rest, then listen to your body and use good judgement afterward, you should be fine.

You should be specific with your doctor about your activity level and your training goals. He/she has a lot more knowledge about what needs to be done in your nose, and should be able to tailor your recovery plan based on that specific knowledge. When I perform this surgery on athletes who want to get back to training, we have a much different conversation than with my "couch potato" patients.

I'm assuming you've established care with a good ENT. If not, seek out one that has an athletic background. I've had a number of patients come to me because they had seen me at the local 10k or sprint tri, and made the connection. Good luck, and feel free to ask questions.

Re: Septoplasty and Turbinate Reduction Recovery Time? [kmill23] [ In reply to ]

Oct 3, 13 11:42

Post #11 of 54 (43380 views)

My patients return to full activity after 14 days. You risk severe epistaxis if you push it before this. Stents x 1 week. There are some things you can do post-operatively to make recovery easier. pm me if you decide to have the surgery and I can give you some advice.

Re: Septoplasty and Turbinate Reduction Recovery Time? [Tri_Mor] [ In reply to ]

Oct 3, 13 12:02

Post #12 of 54 (43367 views)

Tri_Mor wrote:

I'm an ENT, so I perform this surgery regularly. There's no easy answer as to how long your recovery will be. There are quite a few variables, mainly the severity of the deviation. For my motivated athletic patients, I usually tell them to lay off everything for the first week, then begin to ramp things back up the second week and see how it goes (mainly Z2). If you re-introduce high intensity work too soon, you could increase your risk of bleeding while things are still healing. So a reasonable approach would be to plan low intensity work during the second week, and reassess how you feel daily. If things are going well, you could gradually get back to your regular routine. What I've learned over the years, is that every patient recovers differently...and every ENT will give you a different answer as to post surgical activity restriction. If you give yourself that first week to rest, then listen to your body and use good judgement afterward, you should be fine.

You should be specific with your doctor about your activity level and your training goals. He/she has a lot more knowledge about what needs to be done in your nose, and should be able to tailor your recovery plan based on that specific knowledge. When I perform this surgery on athletes who want to get back to training, we have a much different conversation than with my "couch potato" patients.

I'm assuming you've established care with a good ENT. If not, seek out one that has an athletic background. I've had a number of patients come to me because they had seen me at the local 10k or sprint tri, and made the connection. Good luck, and feel free to ask questions.

Not that I need to add to a Dr.'s assessment, even if I did sleep at a Holiday Inn Express, but I did have mine done by an ENT who is an athlete. All American collegiate athlete and she and her husband (Ortho surgeon) both do Tri's now. Def. helped convince me (gains to be had), and worked with me through my recovery when I was freaking out. Sloughing turbinates can be an especially troubling moment at 5:00 a.m., in the dark, getting ready for a run, when you think you just blew brain matter out your nose. :o) So this is really good advice if you can find such an ENT. Really helped me get back into my routine safely and without massive nose bleeds and the requisite visits to repair damage.

If someone develops a restraining device that does NOT feel like a 6" aero bottle straw jammed up into your eye sockets, that person is going to make this procedure much more pleasant. Will also make them a LOAD of money.

On a side note, the "second opinion" doc I saw was doing a clinical study on a balloon procedure to open the nasal passages and he said it was a 15 min procedure and you'd be back at work in an hour. He did it to most of his staff over lunch and they finished the work day. My ins. would not cover clinical trials so the cost of the balloon was way more than my deductible for out patient surgery so I decide on the traditional approach. Sounded like a possible future option if I even need to have to corrected. Any opinion on that procedure?

Re: Septoplasty and Turbinate Reduction Recovery Time? [Tri_Mor] [ In reply to ]

Oct 3, 13 12:10

Post #13 of 54 (43364 views)

Tri_Mor wrote:

I'm an ENT, so I perform this surgery regularly. There's no easy answer as to how long your recovery will be. There are quite a few variables, mainly the severity of the deviation. For my motivated athletic patients, I usually tell them to lay off everything for the first week, then begin to ramp things back up the second week and see how it goes (mainly Z2). If you re-introduce high intensity work too soon, you could increase your risk of bleeding while things are still healing. So a reasonable approach would be to plan low intensity work during the second week, and reassess how you feel daily. If things are going well, you could gradually get back to your regular routine. What I've learned over the years, is that every patient recovers differently...and every ENT will give you a different answer as to post surgical activity restriction. If you give yourself that first week to rest, then listen to your body and use good judgement afterward, you should be fine.

You should be specific with your doctor about your activity level and your training goals. He/she has a lot more knowledge about what needs to be done in your nose, and should be able to tailor your recovery plan based on that specific knowledge. When I perform this surgery on athletes who want to get back to training, we have a much different conversation than with my "couch potato" patients.

I'm assuming you've established care with a good ENT. If not, seek out one that has an athletic background. I've had a number of patients come to me because they had seen me at the local 10k or sprint tri, and made the connection. Good luck, and feel free to ask questions.

Thank you for replying. I certainly value the input of someone who actually performs these procedures. As its 'base' building time anyway, all of my training can be low intensity for a few weeks. I just don't want to NOT train at all. I can deal with 7-10 days of nothing, then getting back to really low intensity stuff. I know recovery is going to suck. But it's going to suck whether I'm sitting on a couch or sitting on my trainer. :-)

I really need to give it a go. I'm just really concerned about missed work, feeling like crap, not being able to be active for a long period of time, the surgery not working, still being the same afterward, etc, etc, etc.

Last edited by: kmill23: Oct 3, 13 12:11

Re: Septoplasty and Turbinate Reduction Recovery Time? [tmshokie] [ In reply to ]

Oct 3, 13 12:15

Post #14 of 54 (43361 views)

Looks like a few physicians commenting. As a patient who had a tough history of sinus issues, it was indeed 2 weeks of rest and recovery for me with a ramp back of working out. Every case is probably a little different but I wouldn't count on jumping right back in.

Some w/ issues like polyps (which can grow back) may need future corrective surgeries apparently, but those are much less invasive if things are done properly the first time.

It was totally worth it for me.

Good luck.

J

Re: Septoplasty and Turbinate Reduction Recovery Time? [rmg] [ In reply to ]

Oct 3, 13 12:22

Post #15 of 54 (43356 views)

I had the procedure done about 2 years ago and, like others have mentioned, it was a great decision. I still remember the first ride I did after the surgery and I could feel air going up my nose when I wasn't even breathing. I had similar sensations/problems swimming, with water going up my nose.

I know I didn't have any stints put in, which was awesome, because I heard that was the worst part. After about a day I felt fine (pain wise), other than when they cleaned out my nose a couple times a week. I remember running and cycling about a week or so after at a light to moderate pace.

Do it. Sleeping through the night, especially after drinking, makes a huge difference!

Re: Septoplasty and Turbinate Reduction Recovery Time? [Sbrans03] [ In reply to ]

Oct 3, 13 12:49

Post #16 of 54 (43339 views)

Are the stints for the septoplasty or the turbinate reduction? I'm thinking of having the reduction done and being able to breath again. My ENT said my septum wasn't too bad but my turbinates are huge and it always feels like I have a stuffed nose

Re: Septoplasty and Turbinate Reduction Recovery Time? [jamgam] [ In reply to ]

Oct 3, 13 13:14

Post #17 of 54 (43333 views)

Stents are typically used after septoplasty. Several different ways to treat turbinate hypertrophy. Medically and surgically. Have you taken nasal steroid therapy for greater than 6 consecutive weeks before ?

Re: Septoplasty and Turbinate Reduction Recovery Time? [rmg] [ In reply to ]

Oct 3, 13 13:57

Post #18 of 54 (43316 views)

I tried, I got one of the sniffer things but I really wasn't a fan. I think after my "A" race next weekend I might try it again and see if it helps but it make my head feel funny. Does that go away?

Re: Septoplasty and Turbinate Reduction Recovery Time? [jamgam] [ In reply to ]

Oct 3, 13 16:24

Post #19 of 54 (43292 views)

Depends on what your sniffing jamgam :)
Topical antihistamines can be used intermittently for short periods of time when symptomatic (astepro, patanase).
Steroid sprays (Flonase/Nasonex etc.) need to be used daily for longer treatment periods and help to prevent symptoms from occurring.

Re: Septoplasty and Turbinate Reduction Recovery Time? [kmill23] [ In reply to ]

Oct 3, 13 16:35

Post #20 of 54 (43290 views)

Everybody's different and I heard tons of stories before I had my surgery. For me it was life changing for the better. Way better sleep, not worrying about choking on dry food, etc. I had no pain, but was quite miserable for the first week. The stints in the nose restrict quite a few facial movements and they'll feel really weird. Once they were out I felt like a new man. I was told not to exercise for 4 weeks and I followed that advice. Not worth trading 4 weeks of fitness for health complications.

Re: Septoplasty and Turbinate Reduction Recovery Time? [rmg] [ In reply to ]

Oct 3, 13 16:35

Post #21 of 54 (43290 views)

rmg wrote:

Depends on what your sniffing jamgam :)
Topical antihistamines can be used intermittently for short periods of time when symptomatic (astepro, patanase).
Steroid sprays (Flonase/Nasonex etc.) need to be used daily for longer treatment periods and help to prevent symptoms from occurring.

Fluticasone Propionate is the stuff which according to google is Flonase

Re: Septoplasty and Turbinate Reduction Recovery Time? [jamgam] [ In reply to ]

Oct 3, 13 16:45

Post #22 of 54 (43282 views)

I would give it a chance. Use it everyday for a month and see how you feel. Steroids are pretty effective. Problem is with getting people to remember to use them daily. I bet it will help.

Re: Septoplasty and Turbinate Reduction Recovery Time? [kmill23] [ In reply to ]

Oct 4, 13 5:49

Post #23 of 54 (43214 views)

I'm also an otolaryngologist (ENT), so would echo the comments made by my colleagues. Usually, but not always, splints are used post-operatively to assist in the healing of the septum and preventing blood or fluid from accumulating between the septal flaps. Studies have shown that routine use of stenting is not always needed, so I use splints on a case by case basis. Patients are more comfortable without splints, but they have a bit more septal mucosal swelling that take a little longer to heal. I let patients exercise one week after surgery and gradually increase intensity as they see fit. You might need to wait a little bit longer to start your Cross Fit. I would just find time to do the surgery in the beginning of your offseason and take a week off. You'll be glad you did it. It will improve the quality of your life, sleep, and make your CPAP easier to use. Good luck.

Re: Septoplasty and Turbinate Reduction Recovery Time? [ironmanfgo] [ In reply to ]

Oct 4, 13 7:23

Post #24 of 54 (43196 views)

ironmanfgo wrote:

I'm also an otolaryngologist (ENT), so would echo the comments made by my colleagues. Usually, but not always, splints are used post-operatively to assist in the healing of the septum and preventing blood or fluid from accumulating between the septal flaps. Studies have shown that routine use of stenting is not always needed, so I use splints on a case by case basis. Patients are more comfortable without splints, but they have a bit more septal mucosal swelling that take a little longer to heal. I let patients exercise one week after surgery and gradually increase intensity as they see fit. You might need to wait a little bit longer to start your Cross Fit. I would just find time to do the surgery in the beginning of your offseason and take a week off. You'll be glad you did it. It will improve the quality of your life, sleep, and make your CPAP easier to use. Good luck.

\

Fixed that for ya! :-D

Seriously, though, I really appreciate the input by the ENTs in this thread. You guys are awesome. I'm really needing to get a good list of items I'll need to stock for recovery. I've read that saline solutions are crucial. Anything else that will be beneficial in my recovery process? I'll likely be alone for most of the recovery, so going out and buying stuff will not be my first priority. I want to get everything well before I have the procedure.

Re: Septoplasty and Turbinate Reduction Recovery Time? [kmill23] [ In reply to ]

Oct 4, 13 7:59

Post #25 of 54 (43190 views)

Funny story. A friend of mine is a Masters state road race champion and has been a team physician for both a Continental and ProTour team part time. I often ask him training advice. I asked him what he was going to do in the offseason. Cross Fit! BTW he's is his late forties, FTP of 325, and weighs 140.
Saline spray or irrigations work well. I find the Neil Med sinus rinse kit easiest to use. If you have the splints, I have patients clean the front of the tubes with a Qtip moistened with hydrogen peroxide to clean any dried blood or mucous to keep them from getting obstructed. Usually there is little pain, and most patients need little or no narcotic pain meds.

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